Provider Demographics
NPI:1609027341
Name:HENDERSON ANESTHESIA LLC
Entity Type:Organization
Organization Name:HENDERSON ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DESHA
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:FRANKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-564-1344
Mailing Address - Street 1:PO BOX 400517
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0517
Mailing Address - Country:US
Mailing Address - Phone:702-564-1344
Mailing Address - Fax:702-564-3211
Practice Address - Street 1:110 WIGWAM PARKWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-564-1344
Practice Address - Fax:702-564-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty